Takase Shiro, Kamigaki Takashi, Yamashita Kimihiro, Nakamura Tetsu, Nishimura Hideki, Sasaki Ryohei
Department of Surgery, Division of Gastro-Intestinal Surgery, Kobe University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2009 Nov;36(12):2006-8.
To suppress local recurrence and preserve sphincter function, we performed preoperative chemoradiotherapy( CRT) of rectal cancer. Sixteen patients with lower advanced rectal cancer received tegafur/uracil/calcium folinate+RT followed by curative resection with lateral lymph node dissection 2-8 weeks later. The male/female ratio was found to be 11:5 (41-75 years old) and the CRT was feasible for all patients. There were 11-PR and 5-SD according to RECIST criteria, and lower isotope accumulation was observed for all primary tumors in FDG-PET study. After CRT, all patients received R0 curative resection (11 APR, 2 LAR, 1 Hartmann and 1 ISR). On pathological study, 3 patients showed complete response. Surgical complications including pelvic infection, delayed a wound healing and deep venous thrombosis, etc. In conclusion, preoperative CRT of advanced rectal cancer could potentially be useful for local control and sphincter saving, however, it is necessary to manage specific surgical complications due to radiation.
为抑制局部复发并保留括约肌功能，我们对直肠癌患者实施了术前放化疗（CRT）。16例低位进展期直肠癌患者接受替加氟/尿嘧啶/亚叶酸钙联合放疗，随后在2 - 8周后进行根治性切除及侧方淋巴结清扫。男女比例为11:5（年龄41 - 75岁），所有患者均可行CRT。根据RECIST标准，有11例部分缓解（PR）和5例疾病稳定（SD），在FDG - PET研究中所有原发肿瘤均观察到较低的同位素摄取。CRT后，所有患者均接受了R0根治性切除（11例腹会阴联合切除术，2例低位前切除术，1例Hartmann术和1例括约肌间切除术）。病理研究显示，3例患者达到完全缓解。手术并发症包括盆腔感染、伤口愈合延迟和深静脉血栓形成等。总之，进展期直肠癌术前CRT可能对局部控制和保留括约肌有用，然而，有必要处理因放疗导致的特定手术并发症。
